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KMID : 1099620070040030151
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Korean Journal of Spine
2007 Volume.4 No. 3 p.151 ~ p.156
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Radiological Study of Subsequent Vertebral Fractures after Percutaneous Vertebroplasty
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Jang Jae-Woong
Park Kwan-Ho
Kim Jae-O
Kim Tae-Wan
Chi Moon-Pyo
Kim Jung-Chul
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Abstract
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Objectives: The object of this study is to investigate the features of the subsequent vertebral fractures after percutaneous vertebroplasty classified adjacent fracture, non-adjacent fracture, refracture.
Methods: Between January 2003 to December 2005, we treated 106 patients older than 65, with compression fracture, 128 vertebral levels, using percutaneous vertebroplasty. The pathologic compression fractures caused by bone tumor (primary and metastatic) were excluded. Follow-up period was from 3 months to 18 months. We reviewed the occurrence of subsequent fracture, site and timing of fracture, presence of trauma and change of Cobb’s angle. We also reviewed change of angulation and loss of vertebral height on refracture patients.
Results: New symptomatic fractures were occurred on twenty patients(18.9%). 19.5(17/85)% of osteoporotic and 15.8(3/19)% of non-osteoporotic patients were occured. The average T-score of osteoporotic patients were -3.64 and non- osteoporotic patients was -2.25. Among them, nine patients were adjacent fracture and five patients were nonadja- cent fracture. Refracture was occurred on six patients. Sixteen patients(80%) were occurred after 3 months to pre- vious vertebroplasty. Only three patients had repeated trauma(slip down). Ten subsequent fractures among fourteen(71.4%) were occurred at upper level vertebrae. The average increase of Cobb’s angle is 1.62. The average increase on refracture patients is 3.57. The average increase of angulation on refracture patients is 9.85.
Conclusion: Subsequent fractures usually occur more than three months later after percutaneous vertebroplasty without truma history. Refractures induce more increase of Cobb’s angle than other subsequent fracture and angulation defor- mity. So, more than three months follow up is needed after vertebroplasty though there is no additional trauma history.
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KEYWORD
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Compression Fracture, Vertebroplasty, Subsequent fracture
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